20 warning signs of compassion fatigue

First responders experiencing secondary traumatic stress due to nature of work

A shoe is seen on the driveway behind the police line which ropes around the house where seven children died from a fatal structure fire in the community of Spryfield in Halifax on Feb. 20. REUTERS/Ted Pritchard

We increasingly hear of compassion fatigue, also known as vicarious trauma or secondary traumatic stress, occurring among police and first responders.

Compassion fatigue is the stress resulting from the traumatized individual rather than the trauma itself. It often involves an intense state of tension or excessive preoccupation with the cognitive, physical, psychological and emotional pain and suffering of trauma survivors.

Providing care to trauma victims, being repeatedly exposed to their traumatic experiences and the empathetic care provided to trauma survivors can lead to increased stress, negative emotional reactions and compassion fatigue, in turn, increasing the risk for burnout.

Recognizing early warning signs and seeking early intervention are important. Compassion fatigue can negatively impact and impair an individual’s personal, social and occupational functioning and psychological health problems such as depression, anxiety disorders, post-traumatic stress disorder and substance use disorders.

Be aware of the following warning signs of compassion fatigue:

Emotional symptoms

•Feeling overwhelmed, hopeless, helpless or powerless when hearing of others’ suffering
•Feelings of anger, irritability, sadness and anxiety
•Feeling detached from your surroundings or from our physical or emotional experience
•Feeling emotionally, psychologically or physically exhausted, burnt out or numbness
•Reduced empathy
•Feeling hypersensitive or insensitive to stories we hear or to emotional material we might hear or see
•Limited tolerance for stress.

Cognitive symptoms

•Constant thinking or dwelling around the suffering of the trauma survivors
•Constant self-blame or thoughts of “I should or could have done more”
•Changes in belief systems (such as belief about self, others, world, future) or meaning in life
•Reduced sense of personal and occupational accomplishment or efficacy
•Difficulty concentrating, focusing or making decisions.

•Self-isolation and withdrawal
•Poor coping such as self-medicating and increase in substance use
•Relationship conflict
•Feeling less efficient or productive at work
•Reduced pleasure in activities we used to enjoy and reduced work satisfaction.

It’s crucial that first responders meet their own mental health needs when they help others. They should be aware and mindful of their thoughts, feelings, physiological changes and any emotions they may be experiencing. They should focus on their breathing and slow down their breathing rate.

Visual reminders, such as photographs or flowers, can be used to stay connected with themselves and appreciate the positives.

Negative thoughts, worries and stressors can be put into perspective and a broader approach can be taken to better evaluate them and identify resources, learning and strengths to help the individual make healthier decisions and move forward. It’s also important to set realistic expectations and focus on what you have control over. The first responder should take time to appreciate themselves and their hard work — they should look at their positives and remind themselves that they don’t have full control over most outcomes. Another point to keep in mind is that pain and suffering are part of life and you don’t always have a lot of control.

Self care is very important. Encourage first responders to consider the following self-care habits:

•Eat healthy, set time for some physical exercise and be kind to themselves
•Engage in proper sleep habits
•Seek quality social support
•Schedule meaningful activities
•Set realistic goals and expectations and practice flexibility when circumstances change
•Keep a sense of humour
•Focus on balancing work and personal life.

Emotional self-care is also critical. First responders must set healthy personal and emotional boundaries in terms of what works for them and what doesn’t, and only take on what they feel they can handle. It’s important to keep in mind that emotional boundaries will likely change over time and that they can maintain compassion, connection and empathy without overly taking on someone else’s pain or suffering or tragedy.

They can focus on a sense of satisfaction from helping trauma survivors while also working on detaching themselves from the suffering of those they are helping. They also need to focus on their own needs, feelings and rights.

We all need to pay greater attention to compassion fatigue, learn resilience pathways to help reduce its risks and further our education, research and treatment on the topic. Hopefully, this will lead to prevention, resiliency and recovery.

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